In India, a lot of kids grow up stunted, which basically means they’re shorter than they should be for their age because they didn’t get enough nutrition early on. It’s a quiet problem, but a huge one. Stunting doesn’t just affect height, it messes with brain development, immunity, and even future earning potential. Once those early years are gone, you can’t fully undo the damage.“Stunting is associated with an underdeveloped brain, with long-lasting harmful consequences, including diminished mental ability and learning capacity, poor school performance in childhood, reduced earnings and increased risks of nutrition-related chronic diseases, such as diabetes, hypertension, and obesity in future,” UNICEF says. “In India, 35 per cent of children younger than five years of age are stunted, a manifestation of chronic undernutrition. Stunting and other forms of under-nutrition are thought to be responsible for nearly half of all child deaths globally,” it adds. Why does this happen? It’s not just about food quantity, but food quality. Many families rely on cheap, filling foods like rice or roti, but kids need protein, vitamins, and minerals to grow properly. Add in poverty, poor sanitation, unsafe drinking water, and repeated infections, and you’ve got a perfect storm. Even kids in households that aren’t “poor” on paper can end up stunted. The frustrating part is that this is preventable. Simple things like better maternal nutrition, breastfeeding support, clean toilets, vaccines, and diverse diets can make a massive difference. India has programs like ICDS and mid-day meals, but gaps in awareness, access, and implementation still exist.Stunted kids aren’t lazy or weak, they’re kids whose bodies didn’t get a fair start. TOI Health spoke to Dr. Vivek Jain, Senior Director & Unit Head – Paediatrics, Fortis Hospital, Shalimar Bagh on what’s failing the children of India.
Why are 35% of Indian children under 5 still stunted, despite years of nutrition programs?
For decades, there has been high-level policy and attention paid to nutrition and several different government-run programs, yet stunting remains a problem for almost 35 percent of children under 5 years old in India. Stunting is not only about the amount of food consumed but also the quality of food; the consistency in delivery, the care practices used, the health environment children are raised in, and the socioeconomics surrounding them. The Integrated Child Development Scheme (ICDS), Poshan Abhiyaan, and Mid-Day Meals programs have all made significant efforts to improve access to nutrition, however, children continue to miss out on receiving adequate nutrients during the first 1,000 days of life due to challenges in program implementation, supply chain issues and ineffective community engagement. In addition, children experience recurrent infections, live in unhygienic environments, and/or were born to mothers who don’t receive adequate nutrition, which only adds to the problem. Thus, policies are developed, but the challenge remains to move from policy to consistent, meaningful impact through the behavior of the community.
Are there particular states or regions where stunting is more prevalent? Why?
Bihar, Uttar Pradesh, Jharkhand, Madhya Pradesh and certain regions of Odisha and Chhattisgarh have more stunted children than any other Indian states (e.g. Kerala or Goa). Poverty, food scarcity, poor nutrition for mothers, unequal access to health care services, and poor sanitation help to create structural obstacles to healthy growth of children which makes location a primary factor impacting risk of being stunted, irrespective of individual decision making.
How much stunting is due to poor nutrition?
Under nutrition is a primary driver of stunting due to under consumption and/or the consumption of low quality foods. However, stunting is multi-dimensional as repeated bouts of infections, poor gut health, and chronic inflammation prevent the proper absorption of nutrients. We agree that the problem cannot be solved by food alone, improvements must also be made in hygiene, maternal health, and child care.
Why is awareness among parents and caregivers about proper child nutrition still so low?
The reason there is very low awareness regarding nutrition knowledge is that nutrition guidelines and education on nutrition have been ineffective in reaching family members. E.g. frontline workers are overwhelmed, there are cultural feeding practices/beliefs, there is low female literacy rate, and the delivery of information is very poor. As a result, caregivers have a very low level of understanding about what to feed their children, when to feed their children, and how to feed their children; therefore, caregivers are not using many of the available nutrition and health services.
If you could prioritize one urgent step to reduce stunting nationwide, what would it be?
Strengthening community-based nutrition and behavior change counseling for the first 1,000 days is an immediate and scalable solution. By providing personalized guidance from Anganwadi workers, practical demonstrations of nutrition practices, family involvement, and implementation of evidence-based supports for breastfeeding, complementary foods, supplementation, immunization and hygiene, families will be able to better understand the supports available to them, allowing for consistent application of these supports, and resulting in longer-term improvements in child growth outcomes.Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr. Vivek Jain, Senior Director & Unit Head – Paediatrics, Fortis Hospital, Shalimar BaghInputs were used to explain stunted growth in kids and how to prevent it.
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